Objective: Electrocardiogram (ECG) signals commonly suffer noise interference, such as baseline wander. High-quality and high-fidelity reconstruction of the ECG signals is of great significance to diagnosing cardiovascular diseases. Therefore, this paper proposes a novel ECG baseline wander and noise removal technology. Methods: We extended the diffusion model in a conditional manner that was specific to the ECG signals, namely the Deep Score-Based Diffusion model for Electrocardiogram baseline wander and noise removal (DeScoD-ECG). Moreover, we deployed a multi-shots averaging strategy that improved signal reconstructions. We conducted the experiments on the QT Database and the MIT-BIH Noise Stress Test Database to verify the feasibility of the proposed method. Baseline methods are adopted for comparison, including traditional digital filter-based and deep learning-based methods. Results: The quantities evaluation results show that the proposed method obtained outstanding performance on four distance-based similarity metrics with at least 20% overall improvement compared with the best baseline method. Conclusion: This paper demonstrates the state-of-the-art performance of the DeScoD-ECG for ECG baseline wander and noise removal, which has better approximations of the true data distribution and higher stability under extreme noise corruptions. Significance: This study is one of the first to extend the conditional diffusion-based generative model for ECG noise removal, and the DeScoD-ECG has the potential to be widely used in biomedical applications.

Study Objectives: Obstructive sleep apnea (OSA) is considered to be an important risk factor for the development of cardiovascular disease (CVD). This study aimed to develop and evaluate a machine ...

The frequency of cortical arousals is an indicator of sleep quality. Additionally, cortical arousals are used to identify hypopneic events. However, it is inconvenient to record electroencephalogram (EEG) data during home sleep testing. Fortunately, most cortical arousal events are associated with autonomic nervous system activity that could be observed on an electrocardiography (ECG) signal. ECG data have lower noise and are easier to record at home than EEG. In this study, we developed a deep learning-based cortical arousal detection algorithm that uses a single-lead ECG to detect arousal during sleep. This study included 1,547 polysomnography records that met study inclusion criteria and were selected from the Multi-Ethnic Study of Atherosclerosis database. We developed an end-to-end deep learning model consisting of convolutional neural networks and recurrent neural networks which: (1) accepted varying length physiological data; (2) directly extracted features from the raw ECG signal; (3) captured long-range dependencies in the physiological data; and (4) produced arousal probability in 1-s resolution. We evaluated the model on a test set (n = 311). The model achieved a gross area under precision-recall curve score of 0.62 and a gross area under receiver operating characteristic curve score of 0.93. This study demonstrated the end-to-end deep learning approach with a single-lead ECG has the potential to be used to accurately detect arousals in home sleep tests.

Deep-learning algorithms hold promise in processing physiological signal data, including electrocardiograms (ECGs) and electroencephalograms (EEGs). However, healthcare often requires long-term monitoring, posing a challenge to traditional deep-learning models. These models are generally trained once and then deployed, which limits their ability to adapt to the dynamic and evolving nature of healthcare scenarios. Continual learning—known for its adaptive learning capabilities over time—offers a promising solution to these challenges. However, there remains an absence of consolidated literature, which reviews the techniques, applications, and challenges of continual learning specific to physiological signal analysis, as well as its future directions. Bridging this gap, our review seeks to provide an overview of the prevailing techniques and their implications for smart healthcare. We delineate the evolution from traditional approaches to the paradigms of continual learning. We aim to offer insights into the challenges faced and outline potential paths forward. Our discussion emphasizes the need for benchmarks, adaptability, computational efficiency, and user-centric design in the development of future healthcare systems.